Tuyển tập báo cáo các nghiên cứu khoa học quốc tế ngành y học dành cho các bạn tham khảo đề tài: Flare hypercalcemia after letrozole in a patient with liver metastasis from breast cancer: a case report | Kuroi et al. Journal of Medical Case Reports 2011 5 495 http content 5 1 495 JOURNALOF medical Ur Case REPORTS CASE REPORT Open Access Flare hypercalcemia after letrozole in a patient with liver metastasis from breast cancer a case report 1 1 1 11 1 Katsumasa Kuroi Toshinari Yamashita Tomoyuki Aruga Kazumi Horiguchi Dai Kitagawa Susumu Sekine Hiromi Tokita1 and Yuka Hirashima2 Abstract Introduction Tamoxifen may occasionally precipitate serious and potentially life-threatening hypercalcemia. However to date this has not been documented with aromatase inhibitors. Case presentation A 65-year-old Japanese woman with liver metastasis from breast cancer was admitted to our hospital with vomiting anorexia fatigue arthralgia muscle pain and dehydration. She had started a course of letrozole five weeks earlier. Our patient s calcium level was mg dL. She was rehydrated and elcatonin was administered. Our patient s parathyroid hormone and parathyroid hormone-related protein levels were not increased and a bone scintigram revealed no evidence of skeletal metastasis. After our patient s serum calcium level returned to within the normal range letrozole was restarted at one-half of the previous dose mg . There were no episodes of hypercalcemia. However 84 days after restarting letrozole our patient again complained of arthralgia and treatment was changed to toremifene. During these periods repeated ultrasonograms revealed no progression of liver metastasis. Conclusion To the best of our knowledge this is the first case report of flare hypercalcemia after treatment with letrozole in a patient with metastatic breast cancer. Introduction Flare reaction a transient exacerbation of symptoms has been described primarily in breast cancer treatment with tamoxifen and in prostate cancer following therapy with luteinizing hormone-releasing hormone analogues 1 2 . However the association between a flare reaction and aromatase inhibitors AIs has not .
